Although the Senate Republicans' bill unveiled Thursday tweaked an earlier House version so that the elderly, as well as the disabled, are somewhat shielded from Medicaid cuts, the federal program's 25 percent cut could eventually limit options for older Americans who need full-time care.

Cuts might also put the squeeze on home health aide services and other home-based help that allow another 15,000 seniors to remain in their homes even as their health declines.

The proposal unveiled by Senate Republicans "includes massive cuts in Medicaid, which is the country's long-term care safety net for older and disabled people who have exhausted their own resources, said C. Brian McGuire, Associate State Director of Advocacy for AARP New Jersey. "Because New Jersey simply can't afford to make up the funding gap, it's clear that quality of care in nursing homes and access to services in the home will be compromised."

Others don't feel the elderly will bear the brunt when state governments look to shave Medicaid expenses.

However, his report warns that once Baby Boomers start entering nursing homes in large numbers, Medicaid funds will be stretched to the breaking point.

"In the next decade, they'll get increasingly old," Holahan said of the Boomers, the oldest of which is now 71 years old. "And they'll be more expensive."

The report estimated that New Jersey taxpayers would have to find another $27.5 billion to make up for the money no longer flowing from Washington. That's an increase of nearly a third - and clearly not politically possible, said McGuire.

Yet there are few obvious places to cut.

If payments to nursing homes are reduced, some facilities may simply refuse to accept Medicaid payments, he said.

While the bulk of Medicaid's cuts are aimed at pruning back the eligibility of healthy adults to pre-Obamacare levels, health experts say it's hard to see how the nursing home population would remain unscathed by the policy changes.

"Put simply, the status quo of today's Medicaid program is unsustainable," it said.

The current Medicaid program is "unfair to taxpayers," and has a bureaucracy that is too large to prevent fraud and mixed results. In addition, too few doctors now participate in the program, it said, citing New Jersey as one of the worst states for Medicaid participation.

To the AARP, however, the looming cuts are a current danger to the elderly. As it wrote on its Facebook page, "The Senate released their draft bill today - and now we know why they kept it secret. It's BAD."